Abstract
The current method to determine the need for chelation in Pb-toxic children (blood Pb: 25-55 ug/dl; EP >35 ug/dl) is based on the result of the CaNa2EDTA provocative test (PbP). The PbP requires an injection and an 8-hour urine collection - difficult to achieve in young children. In this study, a low energy x-ray generator with a silver anode was used to measure Pb Lα XRF from the tibias of 18 children. With the leg immobilized, partially polarized photons were directed at the anteromedial skin surface of the mid-tibia. Based on spectra from a leg phantom and from an amputated adult leg, the nominal detection limit was ~2 ug Pb/gm of bone, when the skin surface dose reached 1.0 rad. Bone Pb XRF measurements were performed 1 week before the PbP and compared to outcomes on the PbP. The results were:
A nominal XRF measurement of >2 ug Pb/gm of bone was unerringly predictive of a positive PbP in this group. Undetectable bone Pb by XRF did not discriminate between Pb-toxic children with positive and negative PbP's. In 2 non-Pb-toxic XRF-positive children, the blood Pb levels were 17 and 20 ug/dl. Non-invasive XRF measurements of cortical bone Pb could be a rapid method to determine the need for chelation in large populations of children.
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Rosen, J., Markowitz, M., Jenks, S. et al. L-X-RAY FLUORESCENCE (XRF): A RAPID ASSESSMENT OF CORTICAL BONE LEAD (Pb) IN Pb-TOXIC CHILDREN. Pediatr Res 21 (Suppl 4), 287 (1987). https://doi.org/10.1203/00006450-198704010-00717
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DOI: https://doi.org/10.1203/00006450-198704010-00717